AB1790-HPR COVID-19: AFTER TWO YEARS OF IATROGENIC AND BIOLOGIC IMMUNIZATION/ VACCINATION DO WE ACTUALLY NEED FURTHER BOOSTER IMMUNIZATION/ VACCINATION?
Authors: C. Pohl
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> The Covid19 pandemic started in late 2019 and went through different phases by spreading from China around the whole globe. During the pandemic different mutation types got predominant from original Wuhan type through Alpha, Delta and Omicron variate BA 1/2 to BA 4/5 with different infectiousity and different potential to harm people´s health status. Immunization/ vaccination program started late 2020, first booster phase started midst of 2021, second booster phase in late 2021/ beginning of 2022 and Omicron specific booster phase midst of 2022. <h3>Objectives</h3> Is there a need of further iatrogenic (booster) immunization/ vaccination after 2 years of immunization/ vaccination program from efficacy driven analysis and safety issues standpoint? <h3>Methods</h3> Analysis of Covid-19 antibody development every three months since August 2021 with comparison of infection rates and assessment of safety parameters by assessing D-Dimers as potential endothelium damage marker in 725 patients (600 female, 125 male, age mean: 62,2 years) of a German rheumatological practice to improve the medical care. <h3>Results</h3> In 99 % of the patients longstanding immune memory could be shown by analyzing the antibody curves in different exemplary shown biologic and iatrogenic immunization pathways after 2 years of immunization/ vaccination program and biologic immunization, mainly by Delta variate since late 2021 and Omicron variate since beginning of 2022. In 38.5 % of the patients the safety concerns of potential endothelium damage by analysing D-Dimers every 3 months showed a side effect potential of at least 8 months after every MRNA/ Vector immunization, but not after protein based vaccination and even not after infections in that amount. <h3>Conclusion</h3> Out of the obligation "nil nocere" no further iatrogenic Covid-19 immunization/ vaccination is of need in nearly all (99 %) already immunized people. At present only adult people with very low antibody levels (at least below 64 BAU/ml) (considering the infection or iatrogenic immunization/ vaccination status and time since last spike protein contact) and not yet immunized adult people should be forseen for iatrogenic immunization/ vaccination with protein based or attenuated viral vaccines or in rare cases one Omicron specific MRNA immunization drug. In that case D-Dimer controls for up to 8 months should be obligatory to detect endothelial damage side effect of MRNA (or Vector) technique. Intense cardiovascular monitoring (small vessels) of MRNA/ Vector immunized people in the next 10 – 20 years is necessary. <h3>References</h3> [1] Pohl C; SAFETY AND EFFICACY ASSESSMENT OF COVID-19 IMMUNIZATIONS/ VACCINATIONS IN PATIENTS OF A GERMAN GENERAL RHEUMATOLOGICAL PRACTICE; EULAR 2022 Poster POS1213; http://dx.doi.org/10.1136/annrheumdis-2022-eular.1389 [2] McConeghy KW et al. Effectiveness of a Second COVID-19 Vaccine Booster Dose Against Infection, Hospitalization, or Death Among Nursing Home Residents - 19 States, March 29-July 25, 2022. MMWR Morb Mortal Wkly Rep. 2022 Sep 30;71(39):1235-1238. doi: 10.15585/mmwr.mm7139a2. PMID: 36173757; PMCID: PMC9533729. [3] Bowe, B. Et al. Acute and postacute sequelae associated with SARS-CoV-2 reinfection. <i>Nat Med</i> 28, 2398–2405 (2022). https://doi.org/10.1038/s41591-022-02051-3 [4] Hui-Lee Wong et al. Surveillance of COVID-19 vaccine safety among elderly persons aged 65 years and older, Vaccine, Volume 41, Issue 2, 2023, Pages 532-539, ISSN 0264-410X, https://doi.org/10.1016/j.vaccine.2022.11.069. [5] Maher AK et al. Transcriptional reprogramming from innate immune functions to a pro-thrombotic signature by monocytes in COVID-19. Nat Commun. 2022 Dec 26;13(1):7947. doi: 10.1038/s41467-022-35638-y. PMID: 36572683; PMCID: PMC9791976. [6] Erich Freisleben; Sie wollten alles richtig machen – Dokumentation eines verschwiegenen Leidens – Bericht eines Hausarztes über die Nebenwirkungen der Corona Impfungen; Nov 11, 2022; Cajus Verlag [7] Positive Testrate Germany – https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus/Testzahl.html <h3>Acknowledgements</h3> Thanks to my family, all my patients and my collegues for supporting me in my research to improve my personal patient care. <h3>Disclosure of Interests</h3> None Declared.